NHS rips up drug rules to give dying patients better final weeks of life

Outcry: The death of Linda O'Boyle, who was denied free treatment after buying a drug to treat her bowel cancer, earlier this year has forced a government rethink into drug rules

Dying patients are to get faster access to new treatments under Government plans to tear up the NHS rulebook.

Ministers want to allow patients to 'die with dignity' by adjusting the way a drug's effectiveness is measured, giving greater value to the final weeks of life.

The deal is being drawn up as part of a review of a controversial ban on patients paying privately for life-extending treatments while receiving NHS care.

The Government has been forced into a rethink by the outcry over the death earlier this year of Linda O'Boyle, a grandmother who was denied free treatment after buying a drug to treat her bowel cancer.

A senior source told the Daily Mail that a compromise being considered would see the drugs rationing body, the National Institute for Clinical Excellence, fundamentally alter the way it assesses which treatments are available on the NHS.

It would be made to give far greater weight to the final stages of a patient's life when deciding whether a new drug should get the green light.

Treatments currently banned from the NHS on cost grounds could become more quickly available.

NICE currently uses complex formulas to calculate so-called 'quality-adjusted life years' - a measure of the quality and quantity of life that a particular drug can bring a patient.

But the way it makes its calculations and dithering over the evaluation process has been heavily criticised. In several cases, it has taken several years for it to approve the use of some drugs.

Adjusting the way NICE assesses new drugs would mean many more of the top-up treatments being paid for by patients becoming available on the NHS, ministers say.

However, their cost would still be taken into account.

Money to pay for faster access to treatments would come, they say, from savings being made in the NHS drugs budget by purchasing cheaper generic products and renegotiating deals with pharmaceutical firms.

Ministers are, however, preparing to allow some patients to pay for some extra drugs that remain unavailable - a move that Left-wing Labour MPs, unions and some doctors claim will lead to a two-tier system based on ability to pay.

Dozens of health service trusts have told cancer patients they cannot buy private drugs while receiving NHS care. But many others have been allowing top-up payments.

A Government source said: 'The issue of top-up payments is massively controversial, but a lot of it could be resolved by changing the way we measure the effectiveness of drugs.

'Those final stages of a life are so important to people - whether it's being around for an important family event, seeing a grandchild born or whatever - so it's right that we look at recognising them better.'

Professor John Harris, an ethics expert at Manchester University, said Nice's current methods for deciding on a drug's availability were less fair than 'tossing a coin'.

He said that whether a drug extends life by a short period is 'quite irrelevant' because 'your life does not diminish in value with diminishing life expectancy'.

The Rules

NICE - nicknamed Nasty by its many critics - has come under fierce attack for the way it chooses which life-saving drugs should be available on the NHS.

Under the current system, it uses something called a 'quality adjusted life year' or QALY.

This determines the cost of a new treatment by working out how much it improves and extends a person's life compared to existing treatments.

One QALY equals one year of perfect health, or two years of 50 per cent perfect health or four years of 25 per cent perfect health.

Generally, if the cost per QALY is below £20,000 the treatment is deemed cost effective and approved.

If it falls between £20,000 and £30,000 NICE will need 'persuasion' to give it the go-ahead and above £30,000 the decision is normally to refuse the drug, although exceptions have been made.

Effectively, this means NICE values a year of quality life at between £20,000 and £30,000.

Critics say the figure it uses has remained the same for nearly a decade, ignoring inflation and rises in NHS spending.

The body has also been attacked for the level of secrecy it attaches to its calculations for each drug.

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NHS rips up drug rules to give dying patients better final weeks of life